肩胛颈骨折非手术治疗和手术治疗的疗效分析

目的探讨肩胛颈骨折有效的治疗方法。方法对1995年8月至2005年8月收治的40例肩胛颈骨折患者的临床资料进行回顾性对比分析。其中轻度移位（分离移位≤10mm、成角移位≤40°）22例，明显移位（分离移位〉10mm、成角移位〉40°）18例；非手术治疗26例（非手术治疗组），手术治疗14例（手术治疗组）。随访时进行临床检查，采用Herscovici功能评估方法。结果40例患者均获随访1—3年。其中非手术治疗组：随访26例，优16例，良2例，可3例，差5例；手术治疗组：随访14例，优12例，良2例。结论轻度移位的肩胛颈骨折适合非手术治疗，而移位明显或伴有同侧锁骨骨折的肩胛颈骨折应采用手术治疗，重建肩关节稳定，减少并发症。

Effect comparison of nonoperative and operative treatment of fracture of scapular neck

Objective To explore the effective method for treatment of fracture of scapular neck. Methods A retrospective analysis of 40 patients with fractures of scapular neck was done. The patients were treated by operation or non-operation from August 1995 to August 2005. According to the degree of displacement,40 cases included 22 mild displaced fractures （ ≤10 mm, ≤40° ） ,and 18 severe displaced fractures （ 〉 10 mm, 〉 40° ）, 26 cases were non-operation and 14 cases by operation. Herscovici score was adopted. Results Forty patients were followed up for 1-3 years. Among 26 patients treated by non-operation, Herscovici score showed that 16 cases achieved the excellent resuh,2 cases good,3 cases fair and 5 cases poor. Of 14 patients. treated by operation, Herscovici score showed that 12 cases achieved the excellent result, 2 cases good. Conclusion Fractures of scapular neck with mild displacement can be treated by non-operation while fractures of scapular with severe displacement or associated with ipsilateral clavical fractures should be treated by operation to reconstruct the stability of shoulder and minimize the complications.